o    English: all speech sounds produced by making exhaled air audible

o    Two ways of producing sound
    at larynx
    further up in vocal tract (tongue, lips)
    
o    How to produce sound at larynx
    changes in breathing: regulate airstream from lungs to atmosphere by changing movements of vocal folds, pharynx, soft-palate, tongue, lips and jaws
    
•    inhalation: take in greater volume more quickly, abduct folds

•    expiration: variable force; use muscles of inhalation to control rate of expiration, adduct

    How to vibrate vocal cords
    
•    NOT rhythmic contraction of laryngeal muscles: would be impossible b/c frequenceies of virbration
•    Changes in air pressure cause vibrations

    o    Adduct folds increase in subglottal pressure force folds apart folds sucked back together (Bernouilli effect)
•    The vibration of vocal cords disturbs airareas of low pressure (rarefaction) alternating with areas of high pressure (compression)
•    Changes in pressure sound at ears
•    Sine waves

    o    Changes in amplitudes: loudness

    o    Changes in frequency: pitch

    o    Normal sounds have fundamental frequency, overtones or harmonics

    o    Mass of folds: critical in voice
    Low pitch of lion’s roar: due to massive fibrous pad that forms part of vocal cords
    Men: more massive vocal cords
    Larger foldsslow vibrationdeeper voice

    o    Producing vowels and constants
    Most vowels are “voiced”: vocal folds produce sounds
    Consonants: can be “voiced” (Z) or “non-voiced” (S)
•    Use higher regions of vocal tract to control by stopping, restricting airflow from vocal folds; use lips, teethaperiodic sound

o    Vocal folds and resonators emphasize and deemphasize certain frequencies
    Never hear sounds produced at vocal foldsevery sound changed by passage thru vocal tract: sinuses/resonating chambers
    Howling monkeys: large hyoid bonepowerful resonator

    o    Age-related changes in voice
    
    Infant larynx is smaller, different proportions
•    Arytenoids are proportionately larger
•    Smaller vocal apparatushigher pitch
•    Larynx sits higher easier to breathe thru nose
    Abrupt change in larynx at pubertycan’t control voice
    Older adult: normal degenerative changes in lamina propria, ossification of thyroid cartilagechanges in fundamental frequency
    Lose your voice vocal fold are irritated
•    Can’t adduct foldsair escapes

o    Singing v. speaking
    Singing: greater thoracic pressure and uneven breathing with changes in resonators

    o    Whispering
    Intercartilaginous portions of vocal folds: open to allow air to escapelesser subglottal pressureslittle vibration of foldslittle tonal quality, low volume

    o    Falsetto
    Allowing only part of vocal folds to vibrate
    Increase range by training which part of vocal folds to vibrate

    o    Colds
    Mucus secretions add mass to folds—decrease in pitch, can’t adduct folds as well

    o    Surgeryscars, fibrotic changes can interfere with voice

-> Most of the facial skeleton is formed by nine bones: four paired (nasal, zygomatic, maxilla, and palatine) and one unpaired (mandible).
-> The calvaria of the new-born infant is large compared with the relatively small fascial skeleton.
-> This results from the small size of the jaws and the almost complete absence of the maxillary and other paranasal sinuses in the new-born skull.
-> These sinuses form large spaces in the adult facial skeleton. As the teeth and sinuses develop during infancy and childhood, the facial bones enlarge.
-> The growth of the maxillae between the ages of 6 and 12 years accounts for the vertical elongation of the child’s face.

The Nasal Bones 

-> These bones may be felt easily because they form the bridge of the nose.
-> The right and left nasal bones articulate with each other at the internasal suture.
-> They also articulate with the frontal bones, the maxillae, and the ethmoid bones.
-> The mobility of the anteroinferior portion of the nose, supported only by cartilages, serves as a partial protection against injure (e.g., a punch in the nose). However, a hard blow to the anterosuperior bony portion of the nose may fracture the nasal bones (broken nose).
-> Often the bones are displaced sideways and/or posteriorly.

The Maxillae 

-> The skeleton of the face between the mouth and the eyes is formed by the two maxillae.
-> They surround the anterior nasal apertures and are united in the medial plane at the intermaxillary suture to form the maxilla (upper jaw).
-> This suture is also visible in the hard palate, where the palatine processes of the maxillae unite.
-> Each adult maxilla consists of: a hollow body that contains a large maxillary sinus; a zygomatic process that articulates with its mate on the other side to form most of the hard palate; and alveolar processes that form sockets for the maxillary (upper) teeth.
-> The maxillae also articulate with the vomer, lacrimal, sphenoid, and palatine bones.
-> The body of the maxilla has a nasal surface that contributes to the lateral wall of the nasal cavity; an orbital surface that forms most of the floor of the orbit; an infratemporal surface that forms the anterior wall of the infratemporal fossa; and an anterior surface that faces partly anteriorly and partly anterolaterally and is covered buy facial muscles.
-> The relatively large infraorbital foramen, which faces inferomedially, is located about 1 cm inferior to the infraorbital margin; it transmits the infraorbital nerve and vessels.
-> The incisive fossa is a shallow concavity overlying the roots of the incisor teeth, just a shallow concavity overlying the roots of the incisor teeth, just inferior to the nasal cavity. This fossa is the injection site for anaesthesia of the maxillary incisor teeth.
-> If infected maxillary teeth are removed, the bone of the alveolar processes of the maxillae begins to be reabsorbed. As a result, the maxilla becomes smaller and the shape of the face changes.
-> Owing to absorption of the alveolar processes, there is a marked reduction in the height of the lower face, which produces deep creases in the facial skin that pass posteriorly from the corners of the mouth.

The Mandible 

-> This is a U-shaped bone and forms the skeleton of the lower jaw and the inferior part of the face. It is the largest and strongest facial bone.
-> The mandibular (lower) teeth project superiorly from their sockets in the alveolar processes.
-> The mandible (L. mandere, to masticate) consists of two parts: a horizontal part called the body, and two vertical oblong parts, called rami.
-> Each ramus ascends almost vertically from the posterior aspect of the body.
-> The superior part of the ramus has two processes: a posterior condylar process with a head or condyle and a neck, and a sharp anterior coronoid process.
-> The condylar process is separated from the coronoid process by the mandibular notch, which forms the concave superior border of the mandible.
-> Viewed from the superior aspect, the mandible is horseshoe-shaped, whereas each half is L-shaped when viewed laterally.
-> The rami and body meet posteriorly at the angle of the mandible.
-> Inferior to the second premolar tooth on each side of the mandible is a mental foramen (L. mentum, chin) for transmission of the mental vessels and the mental nerve.
-> In the anatomical position, the rami of the mandible are almost vertical, except in infants and in edentulous (toothless) adults.
-> On the internal aspect of the ramus, there is a large mandibular foramen.
-> It is the oblong entrance to the mandibular canal that transmits the inferior alveolar vessels and nerve to the roots of the mandibular teeth.
-> Branches of these vessels and the mental nerve emerge from the mandibular canal at the mental foramen.
-> Running inferiorly and slightly anteriorly on the internal surface of the mandible from the mandibular foramen is a small mylohyoid groove (sulcus), which indicates the course taken by the mylohyoid nerve and vessels.
-> These structures arise from the inferior alveolar nerve and vessels, just before they enter the mandibular foramen.
-> The internal surface of the mandible is divided into two areas by the mylohyoid line, which commences posterior to the third molar tooth. -> Just superior to the anterior end of the mylohyoid line are two small, sharp mental spines (genial tubercles), which serve as attachments for the genioglssus muscles.

The Zygomatic Bones 

-> The prominences of the cheeks (L. mala), the anterolateral rims and much of the infraorbital margins of the orbits, are formed by the zygomatic bones (malar bones, cheekbones).
-> They articulate with the frontal, maxilla, sphenoid, and temporal bones.
-> The frontal process of the zygomatic bone passes superiorly, where it forms the lateral border of the orbit (eye socket) and articulates with the frontal bone at the lateral edge of the supraorbital margin.
-> The zygomatic bones articulate medially with the greater wings of the sphenoid bone. The site of their articulation may be observed on the lateral wall of the orbit.
-> On the anterolateral aspect of the zygomatic bone near the infraorbital margin is a small zygomaticofacial foramen for the nerve and vessels of the same name.
-> The posterior surface of the zygomatic bone near the base of its frontal process is pierced by a small zygomaticotemporal foramen for the nerve of the same name.
-> The zygomaticofacial and zygomaticotemporal nerves, leaving the orbit through the previously named foramina, enter the zygomatic bone through small zygomaticoorbital foramina that pierces it orbital surface.
-> The temporal process of the zygomatic bone unites with the zygomatic process of the temporal bone to form the zygomatic arch.
-> This arch can be easily palpated on the side of the head, posterior to the zygomatic prominence (malar eminence) at the inferior boundary of the temporal fossa (temple).
-> The zygomatic arches form one of the useful landmarks for determining the location of the pterion. These arches are especially prominent in emaciated persons.
-> A horizontal plane passing medially from the zygomatic arch separates the temporal fossa superiorly from the infratemporal fossa inferiorly.

Other Bones

There are several other, very important bones in the skull, including the palatine bone, ethmoid bone, vomer, inferior concha and the ossicles of the ear (malleus, incus and stapes). These, however, are covered to greater detail where they are relevant in the head (e.g., ethmoid bone with the orbit and nasal cavity).

Movements of the Temporomandibular Joint

• The two movements that occur at this joint are anterior gliding and a hinge-like rotation.
• When the mandible is depressed during opening of the mouth, the head of the mandible and articular disc move anteriorly on the articular surface until the head lies inferior to the articular tubercle.

• As this anterior gliding occurs, the head of the mandible rotates on the inferior surface of the articular disc.
• This permits simple chewing or grinding movements over a small range.

• Movements that are seen in this joint are: depression, elevation, protrusion, retraction and grinding

• Articulations

  Classified according to their structure, composition,and movability
  •    Fibrous joints-surfaces of bones almost in direct contact with limited movement
      o    Syndesmosis-two bones united by interosseous ligaments
      o    Sutures-serrated margins of bones united by a thin layer of fibrous tissue
      o    Gomphosis-insertion of a cone-shaped process into a socket

  •    Cartilaginous joints-no joint cavity and contiguous bones united by cartilage
      o    Synchondrosis-ends of two bones approximated by hyaline cartilage
      o    Symphyses-approximating bone surfaces connected by fibrocartilage

  •    Synovial joints-approximating bone surfaces covered with cartilage; may be separated by a disk; attached by ligaments 
      o    Hinge-permits motion in one plane only
      o    Pivot-permits rotary movement in which a ring rotates around a central axis
      o    Saddle-opposing surfaces are convexconcave. allowing great freedom of motion
      o    Ball and socket - capable of movement in an infinite number of axes; rounded head of one bone moves in a cuplike cavity of the approximating bone

  Bursae
  •    Sacs filled with synovial fluid that are present where tendons rub against bone or where skjn rubs across bone
  •    Some bursae communicate with a joint cavity 
  •    Prominent bursae found at the elbow. hip, and knee'

  Movements
  •    Gliding
      o    Simplest kind of motion in a joint
      o    Movement on a joint that does not involve any angular or rotary motions
  •    Flexion-decreases the angle formed by the union of two bones
  •    Extension-increases the angle formed by the union of two bones
  •    Abduction-occurs by moving part of the appendicular skeleton away from the median plane of the body
  •    Adduction-occurs by moving part of the appendicular skeleton toward the median plane of the body
  •    Circumduction
      o    Occurs in ball-and-socket joints
      o    Circumscribes the conic space of one bone by the other bone
  •    Rotation-turning on an axis without being displaced from that axis
   

• The palate has a rich blood supply from branches of the maxillary artery.

Stylohyoid Muscle

• Origin: Posterior border of the styloid process of the temporal bone.
• Insertion: Body of the hyoid bone at the junction with the greater horn.
• Nerve Supply: Facial nerve (CN VII).
• Arterial Supply: Muscular branches of the facial artery and muscular branches of the occipital artery.
• Action: Elevates the hyoid bone and base of the tongue.